POS0749 TRANSITION READINESS AMONG FINNISH ADOLESCENTS WITH JIA
Authors: K. Mikola, K. Rebane, H. Kautiainen, K. Aalto
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is the most common persistent rheumatic condition in children [1]. It's nature is chronic (2) and in our own study 40% of patients were transferred to adult clinic when they reached the transition age [3]. A successful transition requires sufficient self-management skills to manage one´s chronic condition and all the tasks involved in it [4]. There are multiple practices to establish the transition readiness and self-management among the adolescents [5]. <h3>Objectives</h3> The purpose of our study was to evaluate transition readiness in Finnish patients with JIA and estimate the usefulness of a specific questionnaire. We aimed to find forecasting values for a successful transition and study the possible consequences of an unsuccessful transition to the disease outcome. <h3>Methods</h3> Our questionnaire was inspired by the Canadian Good2Go questionnaire (www.sickkids.ca/en/patients-visitors/transition-adult-care), and it was part of the routine rheumatological visits in our clinic. Eighty-three patients filled it in between June 2011 and December 2013. The questionnaire was given to patients who were likely to be transferred into an adult clinic, that is patients with a long history of ongoing disease activity and ongoing medication. The questions evaluate the self-management in several aspects, e.g., independence in the disease management (medication, appointments, pain control), everyday life (school, future educational plans, mental support, exercise, sexual health), and substance abuse. We used 13 questions with three answer options (yes =2, partly= 1, or no= 0), higher score indicating better readiness. Patients filled in the questionnaire in the pediatric site. We also gathered information from the first adult visit to assess the success of the transition and its relation to disease activity. The transition was defined successful when the patient attended the first visit at an adult care independently, as scheduled, and the medication was carried out as agreed at last pediatric visit. <h3>Results</h3> The cut-off score for a successful transition by ROC-analysis was 24 (OR 6.11 (95% CI: 1.71 to 1.43)). That is, the best estimate for successful transition is when the score is 24 or more. We were able to receive all necessary information to define the success of the transition from 77 patients. In 55 (71%) patients the transition was estimated as a successful. The mean score 22,5 (SD 2,2) in the transition readiness questionnaire is shown in the Figure 1. Seven patients (9 %) received the maximum score. At the first adult visit, the DAS28 was assessed in 58 patients. If the transition was defined as unsuccessful (score&lt;24), the DAS28 was higher, mean 2.21 (SD 1.14) and if the transition was defined as successful (score≥24) the DAS28 was better, mean 1.35 (SD 0.48), p&lt;0.001. <h3>Conclusion</h3> We found this questionnaire a useful tool to evaluate transition readiness. Determination of a successful transition helps us to discover those adolescents who need more profound support to improve their self-management skills and thus enhance their transition process. An unsuccessful transition has also impact on disease outcome. <h3>References</h3> [1]Ravelli A et al. Juvenile idiopathic arthritis. Lancet 2007;369(9563):767–78. [2]Glerup M et al. Long-Term Outcomes in Juvenile Idiopathic Arthritis: Eighteen Years of Follow-Up in the Population-Based Nordic Juvenile Idiopathic Arthritis Cohort. Arthritis Care Res. 2020;72(4):507–16. [3]Mikola K et al. Transition to adult care in Finnish adolescents with juvenile idiopathic arthritis. Scand J Rheumatol. 2022;51(6):490–4. [4]Lozano P et al. Supporting Self-Management in Children and Adolescents With Complex Chronic Conditions. Pediatrics. 2018;141(Suppl 3): S233–41. [5]Biagioli V et al. Instruments Measuring Self-Care in Children and Young Adults With Chronic Conditions: A Systematic Review. Front Pediatr. 2022; 10:832453. <h3>Acknowledgements</h3> All the patients involved. <h3>Disclosure of Interests</h3> None Declared.